5 ms·

I guess on an emotional level it makes sense for people to believe that if we do a good job of social distancing, we will be rewarded by finishing it sooner. T

by dkarl 7y ago

I guess on an emotional level it makes sense for people to believe that if we do a good job of social distancing, we will be rewarded by finishing it sooner. That's usually how hard things work. But according to my understanding, there is no such thing as a local end to the coronavirus. Even if some locality (city, region, country) implements such effective measures that the virus stops spreading there, they will still be vulnerable to outbreaks so long as they have enough unexposed, non-immune people to sustain person-to-person spread. Unless you hermetically seal your borders a la Plague Inc., the way for a community to go back to normal life is for a critical percentage of people to be exposed so we get herd immunity under the conditions of normal life. In short: It's flattening the curve, not shrinking the area under the curve. The better we do it, the longer it will take. P.S. Since this is inevitably political: in my personal experience the misconception that "the better we do it the sooner we can stop" is being spread by liberal/lefty people who are in favor of strict social distancing for as long as it takes. I think they're trying to rally enthusiasm for compliance, but the fact that this optimistic spin coincides with the political rhetoric from certain conservative ideologues should give them pause. Some politicians are anticipating and subtly fomenting a loss of patience with social distancing, and anything that raises unrealistic expectations plays right into their hands.

kardos 7y ago
> In short: It's flattening the curve, not shrinking the area under the curve. The better we do it, the longer it will take. That's too narrow of a view -- it assumes that we can't raise hospital capacity, that supplies shortages are permanent, that treatments won't be developed, that vaccines are vapourware. The point of flattening the curve is to give enough time for those things to be developed such that we can get hospitalization/death rates down and manage a higher rate of infections.
- mirimir 7y ago
  I agree that effective medicines and/or vaccines would shrink the area aka total percentage of the population that eventually become infected. Although both remain unknowns, let's assume one or two years. Neither adequate supplies nor hospital capacity would shrink the area. But they would increase the maximum tolerable infection rate. That is, the infection rate that wouldn't overwhelm resources, and increase the death rate. Given all that, it seems pretty clear that disruptions will last at least a year or two. Perhaps we could move everyone at risk into isolation camps, and let everyone else get infected and recover, hopefully with some lasting immunity. And then perhaps use antiserum from them to help protect the isolated at-risk populations. However, said isolated at-risk populations would likely be at huge risk of mass die-offs, unless there was substantial compartmentalization. Maybe tent cities?
deleted 7y ago
[deleted]
cameldrv 7y ago
I don't agree with this. Right now we're locking down to get R0 well under 1.0. With its super strict lockdown, Wuhan got it down to supposedly 0.3. That means number of cases goes down by 70% or so roughly every five days. The goal is to get the case count down to in the range of dozens. The better job we do of stopping transmission, the quicker we get out of this phase. Once the case count is sufficiently low, we just need R0 to be less than 1. 0.9 is sufficient. That means that each case infects 0.9 people on average. To do that, we're going to need everyone to wear masks, stop having big gatherings, aggressive rapid testing, and electronic and human contact tracing. The low case count we're going for with the lockdown does two things. First, it stops mass death and hospital overload. Second, with fewer cases, you can actually allocate the manpower to trace all of them thoroughly.
- dan_quixote 7y ago
  > Once the case count is sufficiently low, we just need R0 to be less than 1. 0.9 is sufficient Consider that it takes days-to-weeks for patient-zero to show symptoms, another couple weeks for symptoms to appear in spreadees, and still more days for the government to responds with strict enforcement. This kind of feedback loop will make this kind of control impossible.
  - restalis 7y ago
    The effective phase of infection only starts when the first symptoms occur. The virus is not airborne, it relies on liquid droplets to be inhaled by the next victim, thus even infected, as long as the individual does not exhibit sings of sneezing or coughing, the posed risk of infecting others is quite low.
    - taeric 7y ago
      This feels directly contradictory to every story out right now. Are you sure you have the right?
  - ianburrell 7y ago
    That feedback loop is why need to have widespread testing and contact tracing. First patient may take time to show symptoms but then you test everyone they had contact with and catch positives before they show symptoms or are asymptomatic. Also important is quarantining anyone with symptoms until tests prove they are negative. South Korea and Taiwan show that this kind of control is possible.
yongjik 7y ago
But the better we do, the sooner the crisis will be over. Sure, there will be a drawn-out painful phase of figuring out how to reboot the economy while maintaining social distancing, but it will be much less painful for most people if they don't personally know someone who died. (I said "for most people" because apparently some commenters here think it's fine for people to die as long as they are old.) In South Korea, people have already shifted to complaining that the government didn't prepare well for online school curricula, because that's what people are worried about now. Their children's education.
Hokusai 7y ago
> is being spread by liberal/lefty This part of your message does not help. To divide and radicalize people it will just make society weaker and individuals more irrational. For the virus there is no party lines nor nationalism. For the virus we are all together on this. Social distancing, washing your hands and face masks are effective. And, I hope that next time we will be better prepared for this kind of emergencies. Humanity learns from each challenge.
- dkarl 7y ago
  I would include myself in that "liberal/lefty" group. I saw that several of the comments made prior to mine were blaming calculated conservative manipulation, and I wanted to point out that the misconceptions are also arising naturally on "our side" out of desire to promote compliance and optimism. I didn't expect this issue to become political until I observed it happening. The political aspects of the issue have to be addressed, including the assumption that made-up facts can be benign if they're spoken by the right people with the right intentions.
  - AnimalMuppet 7y ago
    > I didn't expect this issue to become political until I observed it happening. There seem to be people (on both sides) who care more about "winning" against the political "enemy" than they do about literally keeping people from dying. That frightens me, maybe more than the virus does.
    - dkarl 7y ago
      I agree. I have a hard time with the news these days, and I was hoping that a bright side of the coronavirus would be that there would at least be some non-political news that I could follow and chit-chat with people about. Sadly, no.
traitsnspecs 7y ago
I wonder how many people will die from the economic impact of a prolonged shutdown. I wonder how many lonely older folks will wish they were dead now that they can no longer receive the few visitors they had. I'd be willing to bet it's more than the actual numbers affected by a virus and an overburdened hospital system.
- departure 7y ago
  Older folks? I have a mid 30's coworker who used to get most of social activity from the office and tech events and meetups (which is bad for a whole other set of reasons) but even from our fairly active work and friend group chats and you can tell he's really feeling the loneliness and depression. He started drinking more during the week and has mentioned several times that he is very sad and can't wait for this to be all over. I know that there are thousands of people in the exact same scenario.
  - restalis 7y ago
    I come to observe suffering in people on the other end of the spectrum - the social butterflies that are like caged wild animals nowadays. Calling acquintances left and right was ok for the first two weeks or so, but as the quality of the discussed subjects dwindled and with it the frequency of social virtual interactions, there's a clear sign that the self-isolation feels more harsh for extroverted people.
    - hkai 7y ago
      Our company instituted a smart policy that only management need come to the office because they tend to be extroverts unlike the ordinary developers
- nradov 7y ago
  You shouldn't be downvoted. The economy is not some abstract separate thing that can stopped and started at will. A prolonged economic depression will kill people just as surely as the virus. They will die deaths of despair from suicide, substance abuse, and chronic disease over months and years but in the end they'll be dead all the same. Governments can mitigate the problem to a limited extent through temporary measures like giving people money and halting evictions, but that will only help at the margins.
eesmith 7y ago
"It's flattening the curve, not shrinking the area under the curve" That's not necessarily true. Numberphile recently did a piece on "The Coronavirus Curve." It describes "the so-called SIR Model being used to predict the spread of cornavirus." At https://youtu.be/k6nLfCbAzgo?t=920 https://youtu.be/k6nLfCbAzgo?t=920 (15:20 into the video), they point out that in the model, if the infection rate is reduced hugely, not only does the peak get smaller, but so does the total number of infections.
- dkarl 7y ago
  Thanks for the link, that was a fascinating watch, but I don't think they're modeling a return to normal life there. They assume a transmission rate that is decreased by social distancing measures, and they leave the transmission rate constant over time. I think that means they are modeling what happens if we continue the same social distancing practices indefinitely, rather than a return to normal life. Another way of looking at it is that they are modeling herd immunity under social distancing, which is achieved at a lower infection rate than herd immunity under normal social behavior.
  - eesmith 7y ago
    I believe it's the latter - a fast spread will overshoot past the minimum herd immunity, while a slower spread won't, thus resulting in fewer overall deaths and ICU visits. In other words, shrinking the area under the curve while flattening the curve. Of course, that's a highly simplified model, might not be true, etc., etc. But it gives me, a leftist, some support for my belief that some "social distancing for as long as it takes" is a more reasonable viewpoint than no social distancing. (I replaced "strict" with "some" because I prefer the Swedish model - see https://news.ycombinator.com/item?id=22768170 https://news.ycombinator.com/item?id=22768170 . I just haven't a clue for how things will turn out.)
- xscott 7y ago
  That model doesn't account for other countries not following the same (presumably strict) procedures. We aren't islands, and even if there is a short term suppression in your current country, it seems unlikely you're going to quarantine every incoming flight (and its crew!) for 2 weeks per flight. I suspect any model that doesn't result in the majority of the population getting it eventually is probably wrong.
falcolas 7y ago
The biggest problem isn't political, it is that we're limited in how many people can be infected at any given time by our health care system. The capacity of our health care system must be taller than the height of the curve to limit the number of deaths.

by dkarl 7y ago

kardos 7y ago

> In short: It's flattening the curve, not shrinking the area under the curve. The better we do it, the longer it will take. That's too narrow of a view -- it assumes that we can't raise hospital capacity, that supplies shortages are permanent, that treatments won't be developed, that vaccines are vapourware. The point of flattening the curve is to give enough time for those things to be developed such that we can get hospitalization/death rates down and manage a higher rate of infections.

mirimir 7y ago
I agree that effective medicines and/or vaccines would shrink the area aka total percentage of the population that eventually become infected. Although both remain unknowns, let's assume one or two years. Neither adequate supplies nor hospital capacity would shrink the area. But they would increase the maximum tolerable infection rate. That is, the infection rate that wouldn't overwhelm resources, and increase the death rate. Given all that, it seems pretty clear that disruptions will last at least a year or two. Perhaps we could move everyone at risk into isolation camps, and let everyone else get infected and recover, hopefully with some lasting immunity. And then perhaps use antiserum from them to help protect the isolated at-risk populations. However, said isolated at-risk populations would likely be at huge risk of mass die-offs, unless there was substantial compartmentalization. Maybe tent cities?

deleted 7y ago

[deleted]

cameldrv 7y ago

I don't agree with this. Right now we're locking down to get R0 well under 1.0. With its super strict lockdown, Wuhan got it down to supposedly 0.3. That means number of cases goes down by 70% or so roughly every five days. The goal is to get the case count down to in the range of dozens. The better job we do of stopping transmission, the quicker we get out of this phase. Once the case count is sufficiently low, we just need R0 to be less than 1. 0.9 is sufficient. That means that each case infects 0.9 people on average. To do that, we're going to need everyone to wear masks, stop having big gatherings, aggressive rapid testing, and electronic and human contact tracing. The low case count we're going for with the lockdown does two things. First, it stops mass death and hospital overload. Second, with fewer cases, you can actually allocate the manpower to trace all of them thoroughly.

dan_quixote 7y ago
> Once the case count is sufficiently low, we just need R0 to be less than 1. 0.9 is sufficient Consider that it takes days-to-weeks for patient-zero to show symptoms, another couple weeks for symptoms to appear in spreadees, and still more days for the government to responds with strict enforcement. This kind of feedback loop will make this kind of control impossible.
- restalis 7y ago
  The effective phase of infection only starts when the first symptoms occur. The virus is not airborne, it relies on liquid droplets to be inhaled by the next victim, thus even infected, as long as the individual does not exhibit sings of sneezing or coughing, the posed risk of infecting others is quite low.
  - taeric 7y ago
    This feels directly contradictory to every story out right now. Are you sure you have the right?
- ianburrell 7y ago
  That feedback loop is why need to have widespread testing and contact tracing. First patient may take time to show symptoms but then you test everyone they had contact with and catch positives before they show symptoms or are asymptomatic. Also important is quarantining anyone with symptoms until tests prove they are negative. South Korea and Taiwan show that this kind of control is possible.

yongjik 7y ago

But the better we do, the sooner the crisis will be over. Sure, there will be a drawn-out painful phase of figuring out how to reboot the economy while maintaining social distancing, but it will be much less painful for most people if they don't personally know someone who died. (I said "for most people" because apparently some commenters here think it's fine for people to die as long as they are old.) In South Korea, people have already shifted to complaining that the government didn't prepare well for online school curricula, because that's what people are worried about now. Their children's education.

Hokusai 7y ago

> is being spread by liberal/lefty This part of your message does not help. To divide and radicalize people it will just make society weaker and individuals more irrational. For the virus there is no party lines nor nationalism. For the virus we are all together on this. Social distancing, washing your hands and face masks are effective. And, I hope that next time we will be better prepared for this kind of emergencies. Humanity learns from each challenge.

dkarl 7y ago
I would include myself in that "liberal/lefty" group. I saw that several of the comments made prior to mine were blaming calculated conservative manipulation, and I wanted to point out that the misconceptions are also arising naturally on "our side" out of desire to promote compliance and optimism. I didn't expect this issue to become political until I observed it happening. The political aspects of the issue have to be addressed, including the assumption that made-up facts can be benign if they're spoken by the right people with the right intentions.
- AnimalMuppet 7y ago
  > I didn't expect this issue to become political until I observed it happening. There seem to be people (on both sides) who care more about "winning" against the political "enemy" than they do about literally keeping people from dying. That frightens me, maybe more than the virus does.
  - dkarl 7y ago
    I agree. I have a hard time with the news these days, and I was hoping that a bright side of the coronavirus would be that there would at least be some non-political news that I could follow and chit-chat with people about. Sadly, no.

traitsnspecs 7y ago

I wonder how many people will die from the economic impact of a prolonged shutdown. I wonder how many lonely older folks will wish they were dead now that they can no longer receive the few visitors they had. I'd be willing to bet it's more than the actual numbers affected by a virus and an overburdened hospital system.

departure 7y ago
Older folks? I have a mid 30's coworker who used to get most of social activity from the office and tech events and meetups (which is bad for a whole other set of reasons) but even from our fairly active work and friend group chats and you can tell he's really feeling the loneliness and depression. He started drinking more during the week and has mentioned several times that he is very sad and can't wait for this to be all over. I know that there are thousands of people in the exact same scenario.
- restalis 7y ago
  I come to observe suffering in people on the other end of the spectrum - the social butterflies that are like caged wild animals nowadays. Calling acquintances left and right was ok for the first two weeks or so, but as the quality of the discussed subjects dwindled and with it the frequency of social virtual interactions, there's a clear sign that the self-isolation feels more harsh for extroverted people.
  - hkai 7y ago
    Our company instituted a smart policy that only management need come to the office because they tend to be extroverts unlike the ordinary developers
nradov 7y ago
You shouldn't be downvoted. The economy is not some abstract separate thing that can stopped and started at will. A prolonged economic depression will kill people just as surely as the virus. They will die deaths of despair from suicide, substance abuse, and chronic disease over months and years but in the end they'll be dead all the same. Governments can mitigate the problem to a limited extent through temporary measures like giving people money and halting evictions, but that will only help at the margins.

eesmith 7y ago

"It's flattening the curve, not shrinking the area under the curve" That's not necessarily true. Numberphile recently did a piece on "The Coronavirus Curve." It describes "the so-called SIR Model being used to predict the spread of cornavirus." At https://youtu.be/k6nLfCbAzgo?t=920 https://youtu.be/k6nLfCbAzgo?t=920 (15:20 into the video), they point out that in the model, if the infection rate is reduced hugely, not only does the peak get smaller, but so does the total number of infections.

dkarl 7y ago
Thanks for the link, that was a fascinating watch, but I don't think they're modeling a return to normal life there. They assume a transmission rate that is decreased by social distancing measures, and they leave the transmission rate constant over time. I think that means they are modeling what happens if we continue the same social distancing practices indefinitely, rather than a return to normal life. Another way of looking at it is that they are modeling herd immunity under social distancing, which is achieved at a lower infection rate than herd immunity under normal social behavior.
- eesmith 7y ago
  I believe it's the latter - a fast spread will overshoot past the minimum herd immunity, while a slower spread won't, thus resulting in fewer overall deaths and ICU visits. In other words, shrinking the area under the curve while flattening the curve. Of course, that's a highly simplified model, might not be true, etc., etc. But it gives me, a leftist, some support for my belief that some "social distancing for as long as it takes" is a more reasonable viewpoint than no social distancing. (I replaced "strict" with "some" because I prefer the Swedish model - see https://news.ycombinator.com/item?id=22768170 https://news.ycombinator.com/item?id=22768170 . I just haven't a clue for how things will turn out.)
xscott 7y ago
That model doesn't account for other countries not following the same (presumably strict) procedures. We aren't islands, and even if there is a short term suppression in your current country, it seems unlikely you're going to quarantine every incoming flight (and its crew!) for 2 weeks per flight. I suspect any model that doesn't result in the majority of the population getting it eventually is probably wrong.

falcolas 7y ago

The biggest problem isn't political, it is that we're limited in how many people can be infected at any given time by our health care system. The capacity of our health care system must be taller than the height of the curve to limit the number of deaths.